medical essays-第59节
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ream but which not all will ever reach。
First of all； he truly loved his profession。 He had no intellectual ambitions outside of it； literary； scientific or political。 To him it was occupation enough to apply at the bedside the best of all that he knew for the good of his patient； to protect the community against the inroads of pestilence； to teach the young all that he himself had been taught； with all that his own experience had added； to leave on record some of the most important results of his long observation。
With his patients he was so perfect at all points that it is hard to overpraise him。 I have seen many noted British and French and American practitioners； but I never saw the man so altogether admirable at the bedside of the sick as Dr。 James Jackson。 His smile was itself a remedy better than the potable gold and the dissolved pearls that comforted the praecordia of mediaeval monarchs。 Did a patient； alarmed without cause； need encouragement； it carried the sunshine of hope into his heart and put all his whims to flight； as David's harp cleared the haunted chamber of the sullen king。 Had the hour come； not for encouragement； but for sympathy； his face； his voice； his manner all showed it； because his heart felt it。 So gentle was he； so thoughtful； so calm； so absorbed in the case before him； not to turn round and look for a tribute to his sagacity； not to bolster himself in a favorite theory； but to find out all he could； and to weigh gravely and cautiously all that he found； that to follow him in his morning visit was not only to take a lesson in the healing art； it was learning how to learn； how to move； how to look； how to feel； if that can be learned。 To visit with Dr。 Jackson was a medical education。
He was very firm； with all his kindness。 He would have the truth about his patients。 The nurses found it out； and the shrewder ones never ventured to tell him anything but a straight story。 A clinical dialogue between Dr。 Jackson and Miss Rebecca Taylor； sometime nurse in the Massachusetts General Hospital； a mistress in her calling； was as good questioning and answering as one would be like to hear outside of the court…room。
Of his practice you can form an opinion from his book called 〃Letters to a Young Physician。〃 Like all sensible men from the days of Hippocrates to the present； he knew that diet and regimen were more important than any drug or than all drugs put together。 Witness his treatment of phthisis and of epilepsy。 He retained； however； more confidence in some remedial agents than most of the younger generation would concede to them。 Yet his materia medica was a simple one。
〃When I first went to live with Dr。 Holyoke；〃 he says； 〃in 1797； showing me his shop； he said； 'There seems to you to be a great variety of medicines here； and that it will take you long to get acquainted with them； but most of them are unimportant。 There are four which are equal to all the rest； namely； Mercury； Antimony； Bark and Opium。'〃 And Dr。 Jackson adds； 〃I can only say of his practice； the longer I have lived； I have thought better and better of it。〃 When he thought it necessary to give medicine； he gave it in earnest。 He hated half…practicegiving a little of this or that； so as to be able to say that one had done something； in case a consultation was held； or a still more ominous event occurred。 He would give opium； for instance； as boldly as the late Dr。 Fisher of Beverly； but he followed the aphorism of the Father of Medicine； and kept extreme remedies for extreme cases。
When it came to the 〃non…naturals；〃 as he would sometimes call them； after the old physicians；namely； air； meat and drink； sleep and watching； motion and rest； the retentions and excretions； and the affections of the mind；he was； as I have said； of the school of sensible practitioners； in distinction from that vast community of quacks； with or without the diploma； who think the chief end of man is to support apothecaries； and are never easy until they can get every patient upon a regular course of something nasty or noxious。 Nobody was so precise in his directions about diet； air； and exercise； as Dr。 Jackson。 He had the same dislike to the a peu pres； the about so much； about so often； about so long； which I afterwards found among the punctilious adherents of the numerical system at La Pitie。
He used to insist on one small point with a certain philological precision； namely； the true meaning of the word 〃cure。〃 He would have it that to cure a patient was simply to care for him。 I refer to it as showing what his idea was of the relation of the physician to the patient。 It was indeed to care for him； as if his life were bound up in him； to watch his incomings and outgoings； to stand guard at every avenue that disease might enter； to leave nothing to chance； not merely to throw a few pills and powders into one pan of the scales of Fate； while Death the skeleton was seated in the other； but to lean with his whole weight on the side of life； and shift the balance in its favor if it lay in human power to do it。 Such devotion as this is only to be looked for in the man who gives himself wholly up to the business of healing； who considers Medicine itself a Science； or if not a science； is willing to follow it as an art；the noblest of arts； which the gods and demigods of ancient religions did not disdain to practise and to teach。
The same zeal made him always ready to listen to any new suggestion which promised to be useful； at a period of life when many men find it hard to learn new methods and accept new doctrines。 Few of his generation became so accomplished as he in the arts of direct exploration； coming straight from the Parisian experts； I have examined many patients with him； and have had frequent opportunities of observing his skill in percussion and auscultation。
One element in his success； a trivial one compared with others； but not to be despised； was his punctuality。 He always carried two watches；I doubt if he told why； any more than Dr。 Johnson told what he did with the orange…peel；but probably with reference to this virtue。 He was as much to be depended upon at the appointed time as the solstice or the equinox。 There was another point I have heard him speak of as an important rule with him； to come at the hour when he was expected； if he had made his visit for several days successively at ten o'clock； for instance； not to put it off； if be could possibly help it； until eleven； and so keep a nervous patient and an anxious family waiting for him through a long； weary hour。
If I should attempt to characterize his teaching； I should say that while it conveyed the best results of his sagacious and extended observation； it was singularly modest； cautious； simple； sincere。 Nothing was for show； for self…love； there was no rhetoric； no declamation； no triumphant 〃I told you so；〃 but the plain statement of a clear…headed honest man； who knows that he is handling one of the gravest subjects that interest humanity。 His positive instructions were full of value； but the spirit in which he taught inspired that loyal love of truth which lies at the bottom of all real excellence。
I will not say that； during his long career； Dr。 Jackson never made an enemy。 I have heard him tell how； in his very early days； old Dr。 Danforth got into a towering passion with him about some professional consultation； and exploded a monosyllable or two of the more energetic kind on the occasion。 I remember that that somewhat peculiar personage； Dr。 Waterhouse； took it hardly when Dr。 Jackson succeeded to his place as Professor of Theory and Practice。 A young man of Dr。 Jackson's talent and energy could hardly take the position that belonged to him without crowding somebody in a profession where three in a bed is the common rule of the household。 But he was a peaceful man and a peace…maker all his days。 No man ever did more； if so much； to produce and maintain the spirit of harmony for which we consider our medical community as somewhat exceptionally distinguished。
If this harmony should ever be threatened； I could wish that every impatient and irritable member of the profession would read that beautiful； that noble Preface to the 〃Letters；〃 addressed to John Collins Warren。 I know nothing finer in the medical literature of all time than this Prefatory Introduction。 It is a golden prelude； fit to go with the three great Prefaces which challenge the admiration of scholars；Calvin's to his Institutes； De Thou's to his History； and Casaubon's to his Polybius；not because of any learning or rhetoric； though it is charmingly written； but for a spirit flowing through it to which learning and rhetoric are but as the breath that is wasted on the air to the Mood that warms the heart。
Of a similar character is this short extract which I am permitted to make from a private letter of his to a dear young friend。 He was eighty…three years old at the time of writing it。
〃I have not loved everybody whom I have known； but I have striven to see the good points in the characters of all men and women。 At first I must have done this from something in my own nature； for I was not aware of it； and yet was doing it without any plan； when one day；
